Provider Demographics
NPI:1225236060
Name:TORNQUIST, LAWRENCE MAGNUS (EDD)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:MAGNUS
Last Name:TORNQUIST
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 NORTH COURT
Mailing Address - Street 2:SUITE 310
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-8106
Mailing Address - Country:US
Mailing Address - Phone:847-520-7523
Mailing Address - Fax:847-803-2559
Practice Address - Street 1:675 NORTH COURT
Practice Address - Street 2:SUITE 310
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8106
Practice Address - Country:US
Practice Address - Phone:847-520-7523
Practice Address - Fax:847-803-2559
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health